Is Your Appendix Really Necessary?

Sometimes my functional medicine studies take me down rabbit holes. And learning about the appendix was one of those holes. I love sharing what I’m learning, to help you stay healthier too! Do you still have your appendix? Or have you had an appendectomy?

Either way, read on as it turns out there’s more to this little organ than originally thought. So what exactly is your appendix good for? Let’s start with a little appendix primer first, in case you’re not quite sure about this lowly organ. The appendix is a small tubular organ, about the size of your index finger. It is located in the lower-right abdomen between the belly button and the right hip bone.

And it used to be thought of as an “ancillary organ”, that would just be removed if it became inflamed, infected, or ruptured. But new research indicates you might actually want to hang onto your appendix if you can. And if you’ve already had an appendectomy, there’s info for you here too.

Did you ever read the kid’s book, Madeline? When I was about seven, I recall thinking I wanted an appendectomy, just like Madeline had! My sister had had an appendectomy, so why couldn’t I have one too? LOL! Thankfully, I’m glad I still have my appendix intact.

Prophylactic appendectomies

Amazingly, today there are countless examples of people having had prophylactic appendectomy surgery (having their appendix removed by choice). This was typically before setting out on lengthy adventures like climbing Mt. Everest or sailing across oceans. Prophylactic appendectomies were likely a “thing” because you can die fairly quickly from the infection caused by a ruptured appendix, without medical care or antibiotics. And adventurers would potentially be without medical help for an extended period of time. Sadly, I personally know someone who died from a ruptured appendix recently, because she didn’t want to go to the doctor for her intense stomach pain, but wanted to wait it out. So if you have intense stomach pain, always seek treatment from your health care provider.

The importance of the lowly appendix

Recent research(1) shows the appendix is far from being an ancillary organ. And it actually plays a vital role in our gut health and overall immune health. This new research shows that the appendix not only houses a surplus of “good” gut bacteria to help us out when we have an infection like food poisoning, but it also helps to regulate fungi in and on our body.

Studies comparing healthy subjects who still had their appendix intact, with those who had appendectomies 2+ and 5+ years prior to the study, found a significant decline in the gut microbiome populations (both in total numbers and in species), in those who had undergone appendectomies.

A link between the appendix, microbiome, and fungi

The removal of the appendix changes the interaction between gut bacteria and fungi. (Yes, we all have fungus among us.) The removal of the appendix seems to affect both bacteria and fungi. However, the effects of an appendectomy seem to be more noticeable on the fecal fungal community than on the bacteria. The healthy subjects who retained their intact appendix had a larger diversity of healthy gut bacteria and fewer fungal infections. While those who had undergone appendectomies had more imbalances in their fungi populations.

For the subjects who had their appendix removed 5+ years prior, much of their resident gut bacteria had repopulated. However, this was not the case for the 2+ year subjects. But all appendectomy subjects, even after 5 years, still had significant disturbance to their fungal populations. And anecdotally, from my own client population, I’ve seen more fungal infections, including athlete’s foot and candida overgrowth, in clients who’ve had their appendix removed.

The underlying ways in which an appendectomy decreases the gut microbiome population and fungal species, and the results of these changes still need to be explored in future studies. After all, scientists only mapped out the gut microbiome in the last 20 years! But the fact that research shows the appendix actually has a role to play in our overall health, is fascinating to me!

A storehouse for good gut bacteria

In another study(2) from Melbourne’s Walter and Eliza Hall Institute, published in the journal Nature, research shows a network of immune cells in the appendix plays an important role in maintaining digestive health. These innate lymphoid cells (ILCs) found in the appendix are crucial for protecting against bacterial infection, especially in people with compromised immune systems.

Researcher and Professor Gabrielle Belz, says, “We’ve found that ILCs may help the appendix to potentially reseed ‘good’ bacteria within the microbiome – or community of bacteria – in the body. A balanced microbiome is essential for recovery from bacterial threats to gut health, such as food poisoning. The ILCs also help to prevent significant damage and inflammation during a bacterial attack, safeguarding the appendix and helping it to perform an important function in the body—as a natural reservoir for ‘good’ bacteria.”

Can antibiotics prevent an appendectomy?

Yet another study(3) indicates that while surgical removal of the appendix has long been the standard treatment for an inflamed or infected appendix, nearly 80% of people treated with antibiotics did not need to have their appendix removed. And the remaining people who ultimately did need an appendectomy weren’t hurt by waiting (while on antibiotics). So emergency surgery was not necessary in most cases. This is a great example of where antibiotics could be a huge benefit.

These studies shed new light on the importance of the appendix and support the idea that it is not an ancillary organ, after all, should not be removed prophylactically, and potentially not at all if antibiotics can be used to reverse any appendicitis infection.(4)

Is your appendix really necessary?

So what if you’ve already had an appendectomy?

Not to worry, there are several ways you can rebuild your gut microbiome. These include everything from probiotics like MicrobiomeLabs Megasporebiotic, and RestoreFlora, to eating more resistant starches (think tubers and root veggies), to some basics like chewing your food thoroughly to ensure you’re getting all the nutrients out of each meal.

The larger area of concern if you’re missing your appendix may be fungal infections. So that’s something to keep an eye on. Do you easily get fungal infections, like toenail fungus, ringworm (actually a fungus not a worm), athlete’s foot, or candida overgrowth? If so, there are several herbal remedies that may help. Fungal medications like Diflucan can also wreak havoc on the gut microbiome in a similar way as antibiotics do.(5) So it’s a great idea to take antifungals with caution too.

Can you prevent appendicitis?

Appendicitis occurs in about 7% of the population and isn’t necessarily preventable. But studies do suggest that people who eat a diet high in fiber, including lots of veggies, fruits, and whole grains, are less likely to get appendicitis than those who eat the Standard American Diet (SAD), full of processed foods, high in sugar, artificial coloring/flavoring, and low in fiber. So just one more reason to add more veggies to each plate. (Are you eating enough veggies? Hint: EACH meal should be about 50-75% veggies.)

What if you get appendicitis in the future?

You might want to bookmark the reference articles below and ask your healthcare provider about treatment with antibiotics, instead of surgery. Since studies have shown this seems to be a viable option in about 80% of appendicitis cases, it’s worth trying to keep yours if you can.

How can you heal your gut?

Whether or not you’ve had your appendix removed, or still have it intact, it’s always a good idea to ensure your gut is optimally healthy. Recent research has shown that the majority of our immune system, as well as neurotransmitters like serotonin and dopamine, reside in the gut. Happy gut, happy body.

So you’ll want to ensure no overgrowth of good or bad bacteria (yes, an overgrowth of good bacteria can also throw your health off balance), fix any leaky gut (enhanced intestinal permeability), and reverse any candida overgrowth. These are all things I help my clients to do when we work on healing their gut for an overall healthier body. And I’d love to help you too! Book a free discovery call today.

Do you still have your appendix, or have you had an appendectomy? What was your biggest takeaway from this article? Please leave a comment and share with your friends and family too.

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References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483179
  2. https://www.wehi.edu.au/news/immune-cells-make-appendix-silent-hero-digestive-health
  3. https://jamanetwork.com/journals/jama/fullarticle/2320315
  4. https://pubmed.ncbi.nlm.nih.gov/26990957
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315907

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